Does ACE inhibition or AT1 antagonism increase cardiac ACE2 expression and activity?
ACE inhibitors and ARBs increase cardiac ACE2 activity, suggesting their antihypertensive effects may partly involve enhanced Ang II metabolism by ACE2.
Selective blockade of either Ang II synthesis or activity induced increases in cardiac ACE2 gene expression and cardiac ACE2 activity, whereas the combination of losartan and lisinopril was associated with elevated cardiac ACE2 activity but not cardiac ACE2 mRNA. Although the predominant effect of ACE inhibition may result from the combined effect of reduced Ang II formation and Ang-(1-7) metabolism, the antihypertensive action of AT1 antagonists may in part be due to increased Ang II metabolism by ACE2.
Ferrario et al. (2005) studied this question.